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PubMed1988

Waterbed care of narcotic-exposed neonates. A useful adjunct to supportive care.

We describe the neonatal course of 30 antenatal narcotic-exposed newborns, half of whom were randomly assigned to nonoscillating waterbeds and half to conventional bassinets. The infants were comparable at birth regarding drug exposure, ethnicity, maternal medical factors, gestational age, growth, and severity of withdrawal at the time of onset. Evaluation of total and subscores of the abstinence syndrome showed a lower total score and a significantly lower central nervous system subscore on day 5 for infants on waterbeds. The infants on waterbeds required less medication to control symptoms. The waterbed group demonstrated a significantly earlier onset of consistent weight gain as compared with the control group. This study demonstrates that nonoscillating waterbeds are an inexpensive and effective component of supportive therapy in the care of narcotic-exposed neonates.

Beds↗
PubMed1985

DSM-III psychiatric diagnosis of narcotic addicts. Recent findings.

We diagnosed and classified a diverse sample of 133 narcotic addicts using DSM-III criteria. Seventy-seven percent of the sample met criteria for one or more diagnoses on axis I, and 65% met criteria for a personality disorder on axis II. In total, 93% met the criteria for one or more psychiatric disorders other than substance abuse. Although heterogeneity of diagnosis is noted, depressions and personality disorders, often in combination, were most prominent. Several factors related to specific diagnostic groupings are analyzed and their significance for the psychopathology of narcotic addiction is discussed.

Adolescent↗
PubMed1980

Narcotic anesthetic drugs: their effect on biliary dynamics.

Biliary tract resistance was measured in 142 patients during cholecystectomy with the use of narcotic or nonnarcotic anesthesia techniques. If fentanyl citrate (narcotic) was used, there was no difference in the pressures measured in normal ducts between these cases and those patients receiving nonnarcotic anesthesia. When morphine sulfate was administered, the resistance exceeded normal values in five of seven patients with normal ducts.

Anesthetics↗
PubMed1988

Use of the subcutaneous route for the administration of narcotics in patients with cancer pain.

From February 1985 until January 1987, 108 consecutive patients with pain due to advanced cancer requiring parenteral narcotics were treated with a subcutaneous infusion of morphine (62 patients) or hydromorphone (46 patients). Mean maximal daily dose of morphine and hydromorphone was 305 mg (range, 80-3000 mg) and 310 mg (range, 40-4024 mg), respectively. The infusion was maintained for a mean of 31 +/- 16 days (range, 2-156). Seventy patients were treated with a portable pump. Of these patients, 33 (45%) were discharge home for a mean of 29 +/- 20 days. Eighty-six of one hundred eight (86/108, 80%) patients experienced adequate pain control (less than two extra doses of analgesics per day). The duration of the site of the infusion was 7 days (range, 2-31). The mean daily increase in those was 2.4 +/- 1.6% of the initial dose (only 15% of patients needed an increase more than or equal to 5% per day). Systemic toxicity consisted of respiratory depression in two patients, severe sedation in six, and confusion in three; all patients improved upon reduction of the daily dose of narcotics. Local toxicity consisted in infection in two patients, bleeding in one, and chemical irritation in six. Cost analysis shows that subcutaneous infusion reduced costs by either allowing home discharges, or replacing intravenous infusion. The authors conclude that this method is safe and effective in patients admitted and at home, and should be considered the first choice when parenteral analgesia is required.

Cost-Benefit Analysis↗
PubMed1976

Alpha-and beta-halomorphides: stereochemistry, analgesic potency, toxicity, and interaction with narcotic receptors in vitro.

The configuration of the halogen on the C-ring of several alpha- and beta-halomorphides was determined by NMR. The analgesic potencies of these halomorphides and their interactions with narcotic receptors in a rat brain homogenate were measured, as was the toxicity of the alpha- and beta-chloromorphides. The halomorphides were examined as possible irreversible binders to the narcotic receptor.

Analgesics↗
PubMed1994

Transdermal delivery of narcotic analgesics: comparative metabolism and permeability of human cadaver skin and hairless mouse skin.

The permeation of hairless mouse skin and human cadaver skin by narcotic analgesics was investigated to determine the interspecies variation. Permeability coefficients of morphine, fentanyl, and sufentanil across full-thickness hairless mouse skin were 1 order of magnitude higher than those found for human epidermis. The permeability coefficient of morphine for stripped hairless mouse skin was 500-fold higher than that for intact skin, showing the stratum corneum to be the principal barrier to its penetration. The permeability coefficient of fentanyl for stripped hairless mouse skin was also raised, but stripping caused an inappreciable increase in the permeation rate of sufentanil. The thick dermis of excised mouse skin obviously offered a significant resistance to the permeation of these lipophilic compounds. In comparison, the permeability coefficients of fentanyl and sufentanil through stripped cadaver epidermis (n > or = 25) were 67 and 37 higher than for intact human epidermis, respectively. The skin metabolism of the narcotics was investigated. No significant metabolic degradation of morphine, fentnayl, and sufentanil was observed in either fresh human cadaver skin or hairless mouse skin homogenates in the presence of NADPH cofactor, suggesting a low monooxygenase enzyme presence in skin. Moreover, no measurable glucuronidation of morphine took place in human skin or hairless mouse skin. Both processes proceeded rapidly in liver homogenates (mouse) under identical circumstances. It thus appears that these drugs pass through in intact form.

Administration, Cutaneous↗
PubMed1977

Narcotic blockade, length of addiction, and persistence of intravenous morphine self-administration in rats.

Four groups of rats differing in the number of periods of prior exposure to morphine sulphate in the i.v. self-administration paradigm were studied under conditions of narcotic blockade. Three groups of subjects also differing in the amount of prior exposure to morphine sulphate were studied under saline conditions. At effective blocking doses of naloxone, opioid-seeking behavior was eliminated in relatively drug naive animals, whereas the persistence of secondary reinforcers in rats with longer addiction histories served to maintain opioid consumption in the presence of adequate pharmacological blockade. Data from saline-treated animals were very similar to data obtained in naloxone-treated animals. The authors conclude that at adequate blocking doses of narcotic antagonist the length of addiction appears to be the best predictor of opioid consumption.

Animals↗
PubMed1976

Generalization of morphine and lysergic acid diethylamide (LSD) stimulus properties to narcotic analgesics.

The present investigation sought to determine whether the stimulus properties of morphine and lysergic acid diethylamide (LSD) would generalize to several narcotic analgesics which vary in their subjective effects. Morphine and saline served as discriminative stimuli for one group of rats in a 2-lever discrimination task. LSD and saline were discriminative stimuli for a second group. Depression of one lever in an operant chamber resulted in reinforcement following the administration of morphine or LSD and the opposite lever was reinforced after saline. After discriminated responding was stable, stimulus generalization tests with narcotic analgesics and antagonists showed that the stimulus properties of morphine generalized to methadone and meperidine, and partially to pentazocine, all of which produce morphine-like subjective effects in humans. Morphine stimulus properties did not generalize to nalorphine or cyclazocine, which produce dissimilar subjective effects. The stimulus properties of LSD generalized partially to cyclazocine, but not to nalorphine. In humans cyclazocine and nalorphine produce a high incidence of psychotomimetic effects, but the subjective effects of cyclazocine are differentiable from those of LSD.

Analgesics, Opioid↗
PubMed1985

Evidence that the selectively bred long- and short-sleep mouse lines display common narcotic reactions to many depressants.

This report challenges the notion that the long-sleep and short-sleep selectively bred mouse lines display unique narcotic reactions to alcohols. First, we found that the specific ethanol sensitivity hypothesis is not supported by the relevant literature. Second, we found that much of the ambiguity with respect to this hypothesis concerns just pentobarbital. Consequently, the major intent of this paper was to further explore what effect pentobarbital had on these two mouse lines. Additionally, we examined the effects of barbital and ethanol. Our results for each of these compounds clearly indicate that when these mouse lines can be differentiated by particular doses the long-sleep animals always displayed greater narcotic reactions. In this inquiry only one sex was employed, and testing was always initiated at the same time of day. It is our contention that many of the equivocal findings that have been reported concerning pentobarbital are due to combining data from both sexes, circadian rhythmicity, and similar procedural variables.

Alcoholism↗
PubMed1989

Pulse oximetry for monitoring during ward analgesia: epidural morphine versus parenteral narcotics.

A pulse oximeter was used to monitor oxygen saturation in 20 women following cesarean delivery. The patients were randomly assigned to one of two groups. Group A received conventional parenteral narcotics for relief of postoperative pain and group B received epidural morphine. All patients were monitored overnight, and data were stored continuously. There were no statistically significant differences in the low saturation values between the two groups. However, the group A desaturation episodes occurred an average of 2.7 +/- 1.9 hours after the parenteral narcotics were administered, and the group B desaturation episodes occurred an average of 13.7 +/- 5.9 hours after the epidural morphine was administered.

Adult↗
PubMed1980

Animal pharmacology of oxapadol (MD 720111), a new non-narcotic analgesic.

Oxapadol is a non-narcotic analgesic with an unusual chemical structure. It possesses analgesic activity in 4 species similar to that of other non-narcotic reference analgesics. It also shows antipyretic and antiinflammatory effects and in the analgesic dose range is devoid of undesirable neurological, gastro-intestinal and cardiovascular side-effects.

Analgesics↗
PubMed1988

Gastric fluid volume, pH, and emptying in elective inpatients. Influences of narcotic-atropine premedication, oral fluid, and ranitidine.

One hundred and twenty healthy, elective surgical inpatients were randomly assigned to one of four groups. Between two and three hours before the scheduled time of surgery all patients ingested a marker dye, phenol red, 50 mg in 10 ml water, with placebo tablet alone (Groups 1 and 2), placebo tablet with 150 ml oral fluid (Group 3), or oral ranitidine 150 mg with oral fluid 150 ml (Group 4). Patients in Group 1 received oral diazepam or no premedication, while those in Groups 2, 3, and 4 received IM narcotic and atropine one hour preoperatively. Following induction of anaesthesia the residual gastric fluid was aspirated through a Salem sump tube and its volume, pH, and phenol red content measured. Mean volumes were Group 1: 24 ml; Group 2: 13 ml; Group 3: 17 ml; Group 4: 14 ml. Mean pH values were Group 1: 2.99; Group 2: 3.03; Group 3: 3.44; Group 4: 5.28. The amount of phenol red in the samples indicated at least 90 per cent gastric emptying had occurred in 90 per cent of patients. We conclude that, in healthy patients, 150 ml oral fluid is almost completely emptied from the stomach within two hours of ingestion, even when followed one hour later by narcotic-atropine premedication.

Adolescent↗
PubMed2004

Health conditions among aging narcotics addicts: medical examination results.

The study examined health conditions among an aging cohort of male narcotics addicts. This prospective cohort study (1964-1998) included interviews and medical testing for 108 surviving subjects who had been admitted to the California Civil Addict Program during the years 1962 through 1964. Medical testing results were: 51.9% had high blood pressure, 22.4% showed hyperlipidemia, 13.3% had elevated levels of blood glucose, 33.6% had abnormal pulmonary function, half of the sample had abnormal liver function, and 94.2% tested positive for hepatitis C, 85.6% for hepatitis B, 3.8% for syphilis, and 27.3% for TB. The study empirically demonstrated poor health conditions and high morbidity among surviving narcotics addicts.

California↗
PubMedDate not supplied

Inhibition of gastrointestinal transit by morphine and FK 33-824 in the rat and comparative narcotic antagonist properties of naloxone and its N-methyl quaternary analog.

Morphine and the enkephalin-like peptide FK 33-824 given i.p. to rats potently inhibit gastrointestinal transit of a charcoal test meal, the doses inhibiting transit by 50% being respectively about 10 and 1 microgram/kg. These intestinal effects are opiate-specific, locally elicited and presumably involve the same action site since they are reversed by the "peripherally selective" narcotic antagonist N-methyl naloxone with apparent pA2 values of 7.34 and 7.10 respectively against morphine and FK 33-824. The calculated pA2 value for naloxone/morphine with the same in vivo test procedure (8.83) and the relative ability of naloxone and N-methyl naloxone to prevent 3H-etorphine binding to rat brain membranes (IC50 43 and 541 nM), indicate different potency ratios between the two narcotic antagonists in the in vitro binding cell-free system (about 1:10) and in vivo (about 1:30), but the latter ratio agrees with published findings in the isolated guinea pig ileum.

Animals↗
PubMed1982

Quaternary narcotic antagonists' relative ability to prevent antinociception and gastrointestinal transit inhibition in morphine-treated rats as an index of peripheral selectivity.

Single doses of naloxone (0.025 to 0.5 mg/kg) or of one of four quaternary narcotic antagonists (i.e. nalorphine allobromide, nalorphine methobromide, naloxone methobromide or naltrexone methobromide, 1 to 60 mg/kg) were given s.c. to rats before morphine, 5 mg/kg i.v. In the absence of antagonists morphine reduced G.I. transit of a charcoal meal to about 15% of drug-free controls and consistently delayed nociceptive reactions (55 degrees C hot plate) in all animals. Doses of antagonists slightly reducing morphine antinociception (centrally effective = A) and restoring G.I. transit to about 50% of drug-free rats (peripherally effective = B) were estimated. The A:B ratio, indicating peripheral selectivity, was at least 8 for any of the quaternary antagonists given 10 min before morphine, but prolonging this interval may have resulted in a lower figure (i.e. less peripheral selectivity) because of reduced A and increased B. This was definitely so for naltrexone methobromide (A:B, greater than 60 at 10 min, about 1 at 80 min) and was not apparent for nalorphrine methobromide according to available data, which for nalorphrine allobromide and to a lesser extent for naloxone methobromide showed only an increase in B at intervals longer than 10 min. Both morphine-induced antinociception and inhibition of G.I. transit were reduced by naloxone at the lower doses tested and were fully prevented at the higher. These findings indicated that, unlike naloxone, the investigated quaternary narcotic antagonists are interesting prototype drugs for selective blockade of opiate receptors outside the CNS, although certain critical aspects, possibly biological N-dealkylation to the corresponding tertiary antagonists, condition peripheral selectivity.

Analgesia↗
PubMed1977

Barbital-induced changes in sensitivity to the behavioral effects of narcotics.

Twelve male (Spraque-Dawley) rats were trained to respond under a variable-interval 15 sec schedule of sweetened-milk reinforcement. Rats were tested with doses of morphine and methadone, both before and after the development of tolerance to barbital (100 mg/kg, IP). Barbital-tolerant rats were tolerant to the effects of methadone on VI responding but were not tolerant to the effects of morphine. These data demonstrate that tolerance to some narcotics can develop after chronic exposure to drugs other than those of the same pharmacologic class. Furthermore, this investigation demonstrates the necessity of considering changes in the pharmacokinetics of a narcotic as a possible explanation for the development of tolerance to the behavioral effects of the drug.

Animals↗
PubMed1990

Interaction of high pressure and a narcotic dose of ethanol on spontaneous behavior in rats.

This study analyses the spontaneous motor activity of rats that had received a narcotic dose of ethanol (3.5 g/kg) and were then exposed to 1 atmosphere absolute pressure (ATA) air or to 1 or 72 ATA of helium-oxygen (heliox). The ambient temperature was adjusted to offset ethanol-and helium-induced hypothermia. Ethanol administration prevented the occurrence of convulsions but did not alter the total number of myoclonic jerks at stable pressure. The ethanol-intoxicated animals exposed to high pressure did not exhibit normal locomotion but showed a trend towards increased activity during the last observation period. Similar blood and brain concentrations of ethanol were found in the 1 and 72 ATA groups. These results show that exposure to 72 ATA for 40 min started to exert some antagonistic effects, and they suggest that exposure to higher pressures or for a longer period of time may be sufficient to significantly offset the depressant effects of a narcotic dose of ethanol on spontaneous behavior in rats. At the same time, ethanol seems to protect against some aversive effects of high pressure.

Air Pressure↗
PubMed1979

Lethal synergism between morphine or other narcotic analgesics and propranolol.

Interactions of (+/-)-propranolol HCl with various narcotics were determined in albino rats. The 24-h intraperitoneal (i.p.) LD50 of morphine sulfate + saline was 15--16 times greater than for morphine + propranolol in both sexes although morphine was nearly twice as toxic to males as to females. The potency ratios for LD50's with saline vs. with propranolol were: codeine, 1.9, (+/-)-methadone, 6.0; (-)-alpha-acetylmethadol, 2.8 (72 h). The toxicity of levorphanol also was greatly increased with propranolol, but the dose-effect relationship showed non-parallelism vs. levorphanol + saline. Albino mice and mongrel dogs also showed synergism between morphine and propranolol. Mortality after morphine and propranolol was antagonized by naloxone or naltrexone in rats and mice. The potency ratio in rats for morphine + saline vs. morphine + practolol was 3.5. However, the synergism between propranolol and the narcotics probably was unrelated to beta-adrenergic blocking effects of propranolol because of the apparent equivalence of (+)-, (-)- and (+/-)-propranolol in rats for synergism with morphine.

Analgesics, Opioid↗